The Singapore Family Physician
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                                    Vol 44 No. 1 - The Extended Consultation
                                
                            
                        
                    
                    The 4Ps of Formulation & Intervention
                            
                                
                                    The Singapore Family Physician
                                    Vol 44
                                    No 1
                                    - The Extended Consultation
                                
                            
                        
                    
                                13
                                
                                    - 14
                                
                            
                        
                                
                                    1 January 2018
                                
                            
                        
                                0377-5305
                            
                        The next step after the biopsychosocial information is collected from the extended history, extended examination, and extended investigation is the formulation of the 4P factors related to the patient’s problems (Predisposing, Perpetuating, Precipitating, and Protective factors). In this 4P formulation, attention is paid to the genogram, time-line, ROADS of the family, and the patient’s readiness to change. In certain situations, SBAR tool (Situation, Background, Assessment, Recommendation) may be needed to help get a better clarity of the situation and issues. Formulation helps us to be strategic in our psychosocial management.